NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This project was supported by Grant No. EPA-R-822039 between the National Academy of Sciences and the U.S Environmental Protection Agency (EPA), and Grant No. DHHS-U5O/ATU39903 from the Agency for Toxic Substances and Disease Registry, U.S. Department of Health and Human Services, and U.S. Department of Energy. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

Library of Congress Cataloging-in-Publication Data

Waste incineration and public health / Committee on Health Effects of Waste Incineration, Board on Environmental Studies and Toxicology, Commission on Life Sciences, National Research Council.

THE NATIONAL ACADEMIES

National Academy of Sciences

National Academy of Engineering

Institute of Medicine

National Research Council

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. William A. Wulf is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. William A. Wulf are chairman and vice chairman, respectively, of the National Research Council.

Preface

The National Research Council (NRC) established the Committee on Health Effects of Waste Incineration to assess relationships between human health and incineration of hazardous waste, municipal solid waste, and medical waste. In this report, the committee explains its findings and recommendations about waste incineration and public health.

Despite differences in waste composition and incineration processes, the same types of pollutants of concern can be emitted by each kind of incinerator. Therefore, the committee took a generic approach in addressing the dispersion of pollutants from incineration facilities into the environment, pathways of human exposure, possible health effects, social issues, and community interactions. The committee did not compare risks posed by the different types of waste incineration, nor did it assess risks posed by any particular waste-incineration facility. As discussed in this report, even within the same type of waste incineration, there is broad variability in the emission patterns of pollutants, facility-specific emission characteristics (e.g., stack height and local weather conditions that can affect dispersion of released pollutants), the number of people potentially exposed to incineration emissions, and the total contaminant burden of those people resulting from all pollutant sources.

It is also important to keep in mind that the committee was not asked to compare the health risks attributable to waste incineration with those attributable to other waste-management alternatives, such as land disposal. Therefore, the committee took no position on the merits of incineration compared with other waste-management alternatives.

During the course of its deliberations, the committee reviewed scientific

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the NRC's Report Review Committee. The purpose of this independent review is to provide candid and critical comments that assist the NRC in making the published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. The committee wishes to thank the following individuals for their participation in the review of this report: John C. Bailar III, University of Chicago; A. John Bailer, Miami University; Gaylon Campbell, Washington State University; A.J. Chandler, A.J. Chandler & Associates, Ltd.; Caron Chess, Rutgers University Center for Environmental Communication; Walter Dabberdt, National Center for Atmospheric Research; Donald Hornig, Harvard University; Kathryn Kelly, Delta Toxicology Inc.; Richard Magee, New Jersey Institute of Technology; Jonathan Samet, Johns Hopkins University; and Kenneth Sexton, University of Minnesota.

The individuals listed above have provided many constructive comments and suggestions. It must be emphasized, however, that responsibility for the final content of this report rests entirely with the authoring committee and the NRC.

The committee is thankful for the useful input of Kun-Chieh Lee and Sanford S. Penner into its deliberations early in the study. We also wish to express our

appreciation to the following National Research Council staff members for their effective support of our work: Raymond Wassel, Carol Maczka, James Reisa, Bonnie Scarborough, Ruth Crossgrove, Ruth Danoff, Tracie Holby, Katherine Iverson, Catherine Kubik, Eric Kuchner, and others.

Incineration has been used widely for waste disposal, including household, hazardous, and medical waste--but there is increasing public concern over the benefits of combusting the waste versus the health risk from pollutants emitted during combustion. Waste Incineration and Public Health informs the emerging debate with the most up-to-date information available on incineration, pollution, and human health--along with expert conclusions and recommendations for further research and improvement of such areas as risk communication. The committee provides details on:

Processes involved in incineration and how contaminants are released.

Environmental dynamics of contaminants and routes of human exposure.

Tools and approaches for assessing possible human health effects.

Scientific concerns pertinent to future regulatory actions.

The book also examines some of the social, psychological, and economic factors that affect the communities where incineration takes place and addresses the problem of uncertainty and variation in predicting the health effects of incineration processes.

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